Healthcare Provider Details

I. General information

NPI: 1184080665
Provider Name (Legal Business Name): DLR COUNSELING GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 01/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 W PIONEER PKWY STE 300
ARLINGTON TX
76013-7625
US

IV. Provider business mailing address

1401 HIGHWAY 360 APT 924
EULESS TX
76039-5240
US

V. Phone/Fax

Practice location:
  • Phone: 817-683-0722
  • Fax:
Mailing address:
  • Phone: 817-683-0722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number71565
License Number StateTX

VIII. Authorized Official

Name: DANNY ROSS
Title or Position: THERAPIST
Credential: L.P.C.
Phone: 817-683-0722